Bluecross Blueshield of Tennessee jobs

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CHOICES Care Coordinator (Nashville Region - all counties)

BlueCross BlueShield of Tennessee 26 reviews - Nashville, TN
Job. Medical/Pharmacy. The care coordinator assists the enrollee in the identification of appropriate providers and facilitates authorized services in an effort...
14 days ago - save job - block - email - more...

Care Coordinator (Dual Eligible Special Needs Plan) (Memphis...

BlueCross BlueShield of Tennessee 26 reviews - Memphis, TN
Minimum of 5 years healthcare w/ 3 years clinical experience required. 2 years experience in Utilization Management, Case Management or Managed Care....
14 days ago - save job - block - email - more...

Manager, Quality Assurance

BlueCross BlueShield of Tennessee 26 reviews - Chattanooga, TN
BS/BA degree in a Health Care related field or equivalent experience required. Contributes to the BSHP contractual quality improvement related deliverables for...
3 days ago - save job - block - email - more...

Patient Centered Medical Home (PCMH) Coordinator - Middle TN

BlueCross BlueShield of Tennessee 26 reviews - Nashville, TN
The focus of the PQIP Care Coordinator is to promote whole person health support to the member with emphasis on establishment of routine contact with his/her...
3 days ago - save job - block - email - more...

Operations Compliance Analyst - CHOICES

BlueCross BlueShield of Tennessee 26 reviews - Nashville, TN
Monitor various TennCare CHOICES databases to ensure contractual timeliness requirements are met. Routinely evaluate the adequacy of internal controls and the...
1 day ago - save job - block - email - more...

STARS Quality Incentive Consultant (Provider Quality) - Chat...

BlueCross BlueShield of Tennessee 26 reviews - Chattanooga, TN - +2 locations
Ability to understand technical clinical terminology to consistently interact with patients, health plans, pharmacists and clinicians....
11 days ago - save job - block - email - more...

STARS Data/System Intergration Consultant (Provider Quality)...

BlueCross BlueShield of Tennessee 26 reviews - Chattanooga, TN - +2 locations
Possess a deep understanding of the HEDIS and Medicare Stars program and coordinate implementation, maintenance and identification of new technical tools that...
11 days ago - save job - block - email - more...

Advanced Managed Care Nurse

BlueCross BlueShield of Tennessee 26 reviews - Chattanooga, TN
Perform prospective and retrospective medical necessity reviews. Adhere to and apply CMS guidelines when performing care management functions....
18 hours ago - save job - block - email - more...

STARS Risk Adjustment Consultant (Provider Quality) - Chatta...

BlueCross BlueShield of Tennessee 26 reviews - Chattanooga, TN - +2 locations
Bachelor’s degree or equivalent work experience required. 3 years’ experience with compliance audits in the healthcare industry....
11 days ago - save job - block - email - more...

Appeals Nurse Consultant

BlueCross BlueShield of Tennessee 26 reviews - Chattanooga, TN
The primary duty of this position is to research the member's concern and document those findings. Reviews/Screens medical necessity reviews in an organized,...
1 day ago - save job - block - email - more...
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